Median Nerve Block Injections

The median nerve branches off of the brachial plexus (a bundle of nerves in the upper arm). It runs the length of the upper arm, down the forearm, and into the hand, and can be found on both the left and right sides of the body. Because of its length, the median nerve is susceptible to a number of conditions. Lesions to the median nerve can cause weakness or immobility to the areas the median nerve innervates (interacts with). Claw hand is possible if the nerve is completely severed, and carpal tunnel syndrome is possible if the nerve is compressed. Carpal tunnel syndrome is by far the most common cause of median nerve damage.


As with all types of chronic nerve pain, there are many treatment options available including cryotherapy (extreme cold), medications and nerve blocking injections. Nerve Block injections involve injection of a numbing solution into a selective nerve in an attempt to treat and manage pain. The injection can include a steroid (to reduce inflammation) and/or lidocaine or marcaine (to reduce pain). Nerve block injections are used to effectively “turn off” such nerves, and thus reduce any associated inflammation. The effect of these injections lasts between one and four weeks and can be repeated as required. With some conditions however, patients report a total reduction in pain since the initial over- activity of the nerve has been counteracted. In some instances, the patient may experience a more long term loss of pain as a result of localized anesthesia.

The types of medications used are not predetermined, since many options are available. Of course, ultrasound or fluoroscopy (image-guided injections) may work best, since surface anatomy may not be enough to target the extremely small surface area of the nerves in question.

Remember, nerve blocks are not the best treatment for all pain types. Even when they are appropriate, they are usually more effective as part of a more comprehensive treatment strategy.

Depending on the circumstances, complete destruction of the nerve (as opposed to temporary numbing through a local anesthetic) could be considered. This is referred to as a rhizotomy. Aside from the obvious complications of nerve destruction, permanently damaging a nerve may inadvertently and inevitably damage the soft tissue adjacent to that nerve as well.



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